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Pediatric Trauma Center Activation Charge Pricing Transparency: A National Evaluation Of Trauma Activation Cost By Geographical Region And Mortality
*Garrett D Hall1, Luis A de Leon2, *Christi Reeves1, *Katherine Gautreaux1, Trey Babino1, *Julie Hollan1, *John Coley1, *Adam M Vogel1, Sara C Fallon1, *Daniel Rubalcava1, *Allen Milewicz1, *David E Wesson1, *Bindi J. Naik-Mathuria1
1Texas Children's Hospital, Houston, TX;2Baylor College of Medicine, Houston, TX

Purpose: To evaluate pediatric trauma center activation charge pricing of American College of Surgeons (ACS) verified pediatric trauma centers. The study analyzed trauma response activation pricing, geographical region, center level, and regional mortality.
Methods:Published chargemasters were obtained and data price queries were conducted for specific terms. Pricing for multitier activations 1 through 4 was included, tier 1 being a “Full” team activation. The NTDB 2016 Pediatric Annual Report was utilized for geographical evaluation of mortality and injury severity scores. Descriptive statistics were calculated for activation pricing, designation level, and geographical region. The Mann-Whitney and Kruskall Wallis (ANOVA) tests were used to evaluate hypotheses with α=0.05 to assess P value (p<0.05). A 1-4 Likert scale was used to rank each region by number of patients with ISS>15, case mortality percent, and tier 1 charges; with 1 being the highest.
Findings:91% (100/110) of centers had published chargemasters; 82.70% reported tier 1 “full” activation charges, median $9,147.00 (IQR:$6,200.00-$14,076.00), minimum $1,051.00 maximum $82,941.00.

Conclusions:There is regional variability in pricing which may be associated with disease burden and severity. Variability in pricing suggest a need for closer investigation of how trauma activation pricing is established with an opportunity for standardization.

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